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APPJ,JCAT�QN FOR PLUMBING PERMIT
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= ,$ w � Fee t3 '.5-01 O A Licat' h r�ad��q-r�}�+ ,.pf Cu rtino fora permit to install plumbing
o pipes and/o�'r `fi�turpstlistdd4Sn'"EI {lei!lf side hereof, and arees to install sid prices
and/or fixtures in accordance with the provisions of the Plumbing Code of the City of
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PLUMBING INSPECTOR
FEES
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RECORD OF INSPECTION
Underground Rough...
Partial Rough..
Rough. Complete..
\4ain Drain
Final...